Eating a nutritionally adequate diet is possible without wrecking long-term health, the planet, or the pocket
Authors: Marco Springmann
Journal: The Lancet Planetary Health (2023)

Ty Beal and colleagues1Beal T Ortenzi F Fanzo J Estimated micronutrient shortfalls of the EAT–Lancet planetary health diet.Lancet Planet Health. 2023; 7: e233-e237Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar are right to point to the differentiated nutrient needs for women and men. As part of the EAT–Lancet Commission on Healthy Diets from Sustainable Food Systems, we undertook analyses of nutrient adequacy based on population-level recommendations that contain the special needs of all demographic groups, including men and women of different ages and stages in their reproductive life.2Springmann M Wiebe K Mason-D'Croz D Sulser TB Rayner M Scarborough P Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail.Lancet Planet Health. 2018; 2: e451-e461Summary Full Text Full Text PDF PubMed Scopus (360) Google Scholar, 3Willett W Rockström J Loken B et al.Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems.Lancet. 2019; 393: 447-492Summary Full Text Full Text PDF PubMed Scopus (3929) Google Scholar These population-level analyses allow and account for changes in intake for different demographic groups, and separate analyses for these groups can further help for dietary planning and informing policy responses. The Viewpoint by Beal and colleagues is therefore a very welcome contribution. However, in analysing their proposed diet, we found that it could have adverse implications for both human and planetary health. Compared with current global average intakes, their diet contains 57% more beef and 370% more fish, and compared with the EAT–Lancet planetary health diet, the diet proposed by Beal and colleagues contains fewer vegetables and fewer wholegrains. According to a new analysis based on published models for dietary impact assessment,4Springmann M Spajic L Clark MA et al.The healthiness and sustainability of national and global food based dietary guidelines: modelling study.BMJ. 2020; 370m2322PubMed Google Scholar, 5Springmann M Clark MA Rayner M Scarborough P Webb P The global and regional costs of healthy and sustainable dietary patterns: a modelling study.Lancet Planet Health. 2021; 5: e797-e807Summary Full Text Full Text PDF PubMed Scopus (43) Google Scholar we estimated that adopting Beal and colleagues' "adequate diet" could result in about 1 million additional diet-related deaths annually compared with the planetary health diet. These estimated deaths would stem from less intake of vegetables and wholegrains, and more intake of red meat. Although the planetary health diet would be associated with large reductions in environmental resource use and pollution, the diet proposed by Beal and colleagues could result in substantial increases (eg, 43–64% more greenhouse gas emissions and 26% more cropland use than the current environmental effects of diets globally). Such changes would accelerate climate change and the associated health impacts and would put extra pressure on ecosystems and biodiversity. If globally adopted, the diet would exceed the food-related planetary boundaries that define a safe operating space for humanity. Furthermore, the diet proposed by Beal and colleagues is a third more expensive than the planetary health diet, which makes it not only more expensive in countries such as the USA and the UK, but it would also more than double the cost of diets in low-income countries and therefore be truly unaffordable. A comprehensive diet and food-system analysis could have easily identified nutrient-dense foods for population groups with special nutrient needs that are healthier, more environmentally sustainable, and affordable than what Beal and colleagues proposed. It is now well recognised that even completely plant-based diets can be nutritionally adequate for all life stages.6Melina V Craig W Levin S Position of the Academy of Nutrition and Dietetics: vegetarian diets.J Acad Nutr Diet. 2016; 116: 1970-1980Summary Full Text Full Text PDF PubMed Scopus (598) Google Scholar The planetary health diet can include low to moderate amounts of animal source foods, which makes adjusting for special needs easy and straightforward. For example, increasing the relative amounts of dark green leafy vegetables or focusing on shellfish for fish intake would increase both iron and calcium, and small amounts of nutritional yeast or algae would increase B vitamins.2Springmann M Wiebe K Mason-D'Croz D Sulser TB Rayner M Scarborough P Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail.Lancet Planet Health. 2018; 2: e451-e461Summary Full Text Full Text PDF PubMed Scopus (360) Google Scholar Thus, eating a nutritionally adequate diet is possible without wrecking long-term health, the planet, or the pocket. The challenge is to ensure that nutritionally important foods are available in local markets, especially for those vulnerable populations most in need. MS acknowledges funding from the Wellcome Trust through two grants: "Wellcome Trust Our Planet Our Health partnership on Livestock, Environment and People" (205212/Z/16/Z) and Wellcome Career Development Award "Towards the full cost of diets: valuing and attributing food system externalities to improve decision-making for human and planetary health" (225318/Z/22/Z). MS also acknowledges past consulting fees to undertake research for the EAT–Lancet Commission, also funded by the Wellcome Trust. Estimated micronutrient shortfalls of the EAT–Lancet planetary health dietUnhealthy diets are a major contributor to the global burden of disease, and food systems cause substantial environmental destruction. To lay out how to achieve healthy diets for all, within planetary boundaries, the landmark EAT–Lancet Commission proposed the planetary health diet, which includes a range of possible intakes by food group and substantially restricts the intake of highly processed foods and animal source foods globally. However, concerns have been raised about the extent to which the diet provides adequate essential micronutrients, particularly those generally found in higher quantities and in more bioavailable forms in animal source foods. Full-Text PDF Open AccessEating a nutritionally adequate diet is possible without wrecking long-term health, the planet, or the pocket – Authors' replyMarco Springmann1 proposes how to eat a nutritionally adequate diet without wrecking long-term health, the planet, or the pocket.1 We agree on this goal but are concerned that Springmann does not acknowledge important flaws in the EAT–Lancet's adequacy assessment, which we find lead to the promotion of a diet that is inadequate in some micronutrients.2 Instead of addressing these flaws, Springmann uses the same approach to estimate the effects of a hypothetical, micronutritionally adequate, diet in our Viewpoint on long-term health, the planet, and the pocket. Full-Text PDF Open Access